Leukemias, lymphomas, and other hematologic cancers:

Indications for XPOVIO:

In combination with dexamethasone for the treatment of adults with relapsed or refractory multiple myeloma (MM) in adults who have received at least 4 prior therapies and whose disease is refractory to at least 2 proteasome inhibitors, at least 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody. Relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least 2 lines of systemic therapy.


Premedicate with 5-HT3 antagonists and/or other anti-nausea agents prior to and during treatment. Swallow whole. Continue until disease progression or unacceptable toxicity. MM: 80mg on Days 1 and 3 of each week. Give oral dexamethasone 20mg with each Xpovio dose on scheduled days. DLBCL: 60mg on Days 1 and 3 of each week. Dose modification for adverse reactions: see full labeling.


Not established.


Monitor CBC with differential (eg, platelets, WBC), blood chemistries (eg, sodium), body weight, nutritional and volume status at baseline, during treatment (more frequently for first 3 months), and as clinically indicated. Monitor for signs/symptoms of bleeding, infection; evaluate promptly. Consider supportive measures for signs of infection (eg, antimicrobials, G-CSFs). Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction. Correct sodium levels for concurrent hyperglycemia and high serum paraprotein levels. Maintain adequate hydration and caloric intake. Embryo-fetal toxicity. Pregnancy: exclude status prior to initiation. Advise females of reproductive potential and males (w. female partners) to use effective contraception during and for 1 week after the last dose. Nursing mothers: not recommended (during and for 1 week after the last dose).

Pharmacologic Class:

Nuclear export inhibitor.


Avoid concomitant medications that can exacerbate dizziness or mental status changes.

Adverse Reactions:

Thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea, upper respiratory tract infection, pyrexia, lymphopenia; infections (eg, pneumonia, sepsis), neurological toxicity.

Generic Availability:


How Supplied:

Tabs—8, 12, 16, 20, 24, 32

Pricing for XPOVIO

4 blister packs of 5 tablets each of 20mg carton (Qty: 1)
Appx. price $22450